肌肉骨骼医学中的肽疗法 资料

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

• Injectable peptide therapy may possess significant therapeutic and regenerative potential [1].
• There is a current lack of evidence to support the clinical use of injectable peptides in orthopaedic and sports medicine [1].
• Peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care due to the lack of robust efficacy and safety data [2].
• Injectable peptides for sports medicine remain largely experimental [4].
• BMP-2 and BMP-7 are the only growth factors that can be recommended based on level I studies [5].
• BMP currently has two FDA-approved indications: treatment of open tibial fractures treated with intramedullary fixation and treatment of tibia long bone non-union [6].
• Peptides are being widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight [7].
• Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis [8].
• A better understanding of exosome mechanisms and standardized isolation methods is required before clinical application [8].
• GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight [9].
• Therapeutic strategies for microfracture augmentation, such as trypsin pretreatment and growth factor–functionalized self-assembling peptide hydrogel scaffold, can be cost-effective ways to improve cartilage healing outcomes [10].
• The use of BPC-157 for sports performance and recovery is not recommended because there are no randomized controlled trials investigating its use in human subjects [11].
• The science is clearly lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 in sports enhancement in athletes [11].
• Various materials are on the market for which no clinical or experimental long-term data on soft tissue or bone reaction is available [12].
• Loss of function in musculoskeletal tissues initiates from either a failure of the cells that produce and maintain the extracellular matrix (ECM) or as a consequence of material failure of the ECM itself [24].
• Advances in the identification of candidate therapeutic cell populations and the development of new biomaterials have occurred over the last three decades to address degenerative processes in musculoskeletal tissues [24].
• Therapeutic cell populations and biomaterials can be applied alone or in combination to promote healing that alters the trajectory of disease or potentially replace an entire tissue when damage has progressed to later stages [24].

How It Works

Clinical Status and Recommendations

• Orthopaedic and sports medicine providers must understand the current lack of evidence to support the clinical use of peptide therapy, despite its potential therapeutic and regenerative properties [1].
• The science is lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 in sports enhancement in athletes [11].
• Peptides are widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight [7].

Growth Factors and BMPs

• Only BMP-2 and BMP-7 can be recommended based on level I studies [5].
• BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability in a rat rotator cuff tear model [18].

Mechanistic and Preclinical Findings

• GHRP-2 administration reduced M1 macrophage polarization and enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model [19].
• Functionalized self-assembled peptides promote the differentiation of ADSCs into nucleus pulposus-like cells [20].
• Axon preservation and minimal inflammation were observed in animals treated with BDNF-incorporated hydrogel, indicating potential for further evaluations in severe spinal cord injury therapies [21].
• Exosomes offer a cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis [8].
• A better understanding of exosome mechanisms and standardized isolation methods is required before their clinical application [8].
• Treatment of defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment in an equine model [14].
• The improvement in clinical symptoms from KLD or microfracture treatment likely resulted from different causes depending on the specific treatment used [14].

Adjunctive and Topical Applications

• Therapeutic strategies for microfracture augmentation, such as those using trypsin pretreatment and growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes [10].
• EGYFIL, a topical lotion based on hyaluronic acid and peptides, is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment [16].
• Reduction in pain and stiffness with EGYFIL occurs already after 3 h from the first application [16].

Adjunctive Pharmacology

What the Evidence Shows

Clinical Status and Recommendations

• Orthopaedic and sports medicine providers must understand the current lack of evidence to support the clinical use of peptide therapy [1].

Regulatory and Market Context

Growth Factors and BMPs

Experimental and Preclinical Findings

• Therapeutic strategies for microfracture augmentation, such as trypsin pretreatment and growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes in an equine model [10].

Topical and Adjunctive Applications

• EGYFIL, a topical lotion based on hyaluronic acid and peptides, is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application [16].

Mechanistic Associations

• The expression of substance P and calcitonin gene-related peptide is associated with the severity of tendon degeneration in lateral epicondylitis [30].

Practical Considerations

• Orthopaedic and sports medicine providers must understand the current lack of evidence supporting the clinical use of peptide therapies [1].
• Peptide supplements should not be recommended as a replacement or adjunct for existing orthopaedic standard of care due to a lack of robust efficacy and safety data [2].
• Therapeutic strategies for microfracture augmentation, such as those using growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes [10].
• Treatment of defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment [14].
• EGYFIL is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application [16].

Key Evidence

• [L5] While peptide therapy may possess significant therapeutic and regenerative potential, it is critical that orthopaedic and sports medicine providers understand the current lack of evidence to support the clinical use of these peptides. [1] (10.1177/03635465251357593)
• [L5] Because of the lack of robust efficacy and safety data, peptide supplements should not currently be recommended as a replacement or adjunct for existing orthopaedic standard of care. [2] (10.1177/03635465261464420)
• [L5] Injectable peptides for sports medicine remain largely experimental. [4] (10.2106/jbjs.rvw.26.00027)
• [Paper] Today only BMP-2 and BMP-7 can be recommended based on level I studies. [5] (10.1016/s0020-1383(08)70014-7)
• [Paper] The use of BMP currently has two FDA-approved indications: treatment of open tibial fractures treated with intramedullary fixation and treatment of tibia long bone non-union. [6] (10.1016/s0020-1383(13)70008-1)
• [Paper] Peptides are being widely advertised and sold through social media, often with exaggerated claims and minimal regulatory oversight. [7] (10.1177/2325967126s00290)
• [L5] Exosomes offer a promising cell-free alternative to mesenchymal stem cell therapies for upper-extremity tissue regeneration by overcoming limitations such as donor-site morbidity and tumorigenesis, though a better understanding of their mechanisms and standardized isolation methods is required before clinical application. [8] (10.1016/j.jhsa.2023.11.016)
• [Paper] While efficacious, GLP-1 agonists may not produce sufficient weight loss to achieve body mass index cutoffs for total joint arthroplasty depending on individual patient factors, including starting bodyweight. [9] (10.2106/jbjs.rvw.23.00167)
• [L5] Therapeutic strategies for microfracture augmentation, such as those presented in this study, can be cost-effective ways to improve cartilage healing outcomes. [10] (10.1177/03635465211021798)
• [L5] The authors do not recommend the use of BPC-157 for sports performance and recovery because there are no randomized controlled trials investigating its use in human subjects, and the science is clearly lacking to determine the overall effectiveness, safety profile, and clinical indications for sports enhancement in athletes. [11] (10.1016/j.arthro.2024.09.005)
• [Paper] However, various materials are on the market for which no clinical or experimental long-term data on soft tissue or bone reaction is available. [12] (10.1016/s0020-1383(02)00128-6)
• [L5] Treatment of defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment; the improvement likely resulted from different causes depending on the treatment. [14] (10.2106/jbjs.m.01408)
• [L4] EGYFIL is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application. [16] (10.1186/s12891-023-06903-y)
• [L5] BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability. [18] (10.1016/j.jse.2026.04.003)
• [L5] GHRP-2 administration reduced M1 macrophage polarization and enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model. [19] (10.1016/j.arthro.2024.11.094)
• [L5] The functionalized self-assembled peptide promotes the differentiation of ADSCs into nucleus pulposus-like cells. [20] (10.1186/s13018-022-03102-8)
• [L5] Although locomotor functional recovery was not observed, axon preservation and minimal inflammation in animals treated with BDNF-incorporated hydrogel indicate the potentiality of the designed intervention for further evaluations in the path of developing efficient therapies for severe spinal cord injury. [21] (10.1016/j.injury.2018.12.027)
• [Paper] The expression of substance P and calcitonin gene-related peptide is associated with the severity of tendon degeneration in lateral epicondylitis. [30] (10.1186/s12891-021-04067-1)

References

[1] Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251357593

[2] Peptide Supplements and Their Therapeutic Applications in Sports Medicine. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465261464420

[4] Injectable Peptides in Sports Medicine: A Structured Narrative Review of Evidence, Safety, and Antidoping Implications. JBJS Reviews. 2026. DOI: 10.2106/jbjs.rvw.26.00027

[5] Carrier systems and application of growth factors in orthopaedics. Injury. 2008. DOI: 10.1016/s0020-1383(08)70014-7

[6] Clinical applications of growth factors in bone injuries: Experience with BMPs. Injury. 2013. DOI: 10.1016/s0020-1383(13)70008-1

[7] Paper 32. Performance & Promises: A Social Media Review of Alleged Indications, Risks and Usage of “Peptides” in Musculoskeletal Health. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00290

[8] The Role of Exosomes in Upper-Extremity Tissue Regeneration. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.016

[9] Glucagon-like Peptide-1 Agonists. JBJS Reviews. 2024. DOI: 10.2106/jbjs.rvw.23.00167

[10] Microfracture Augmentation With Trypsin Pretreatment and Growth Factor–Functionalized Self-assembling Peptide Hydrogel Scaffold in an Equine Model. The American Journal of Sports Medicine. 2021. DOI: 10.1177/03635465211021798

[11] Injectable Therapeutic Peptides—An Adjunct to Regenerative Medicine and Sports Performance?. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.09.005

[12] Biodegradable implants in soft tissue refixation: Experimental evaluation, clinical experience, and future needs. Injury. 2002. DOI: 10.1016/s0020-1383(02)00128-6

[14] Effects of the Combination of Microfracture and Self-Assembling Peptide Filling on the Repair of a Clinically Relevant Trochlear Defect in an Equine Model. Journal of Bone and Joint Surgery. 2014. DOI: 10.2106/jbjs.m.01408

[16] A pre-market interventional, single-arm clinical investigation of a new topical lotion based on hyaluronic acid and peptides, EGYFILTM, for the treatment of pain and stiffness in soft tissues. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06903-y

[18] Effects of BMP-7 and Low Molecular Weight Peptide Solution on Healing in a Rotator Cuff Tear Model: A Histopathological and Biomechanical Study in Rats. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.04.003

[19] Growth Hormone–Releasing Peptide 2 May Be Associated With Decreased M1 Macrophage Production and Increased Histologic and Biomechanical Tendon‐Bone Healing Properties in a Rat Rotator Cuff Tear Model. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.11.094

[20] Self-assembling peptides with hBMP7 biological activity promote the differentiation of ADSCs into nucleus pulposus-like cells. Journal of Orthopaedic Surgery and Research. 2022. DOI: 10.1186/s13018-022-03102-8

[21] Biofunctionalized peptide-based hydrogel as an injectable scaffold for BDNF delivery can improve regeneration after spinal cord injury. Injury. 2019. DOI: 10.1016/j.injury.2018.12.027

[24] Orthopaedic Basic Science Fifth Edition Print Ebook. Cells and Materials for Soft-Tissue Repair and Regeneration > Introduction.

[30] The expression of substance P and calcitonin gene-related peptide is associated with the severity of tendon degeneration in lateral epicondylitis. BMC Musculoskeletal Disorders. 2021. DOI: 10.1186/s12891-021-04067-1